The US will have to test 20 million people a day before they can safely release the lockdown, experts warn
As President Donald Trump increases public support for lifting the blockages of the coronavirus and reopening the economy, a two-tier panel of experts has released a ‘roadmap’ to ensure that it is done safely with more efforts in the area of testing, tracing and isolation.
In a report Under the title “Roadmap to Pandemic Resilience,” released Monday, more than 45 leading economists, social scientists, lawyers, and ethicists warned that sending Americans back to work too soon will revive COVID-19 economy would cost trillions of dollars.
The experts called COVID-19 “a major threat to our democracy, similar to the Great Depression and World War II,” because they outlined the three main components to safely end quarantine: testing, tracking, and supported isolation – a combination known under the acronym TTSI.
The most critical part of TTSI containment is testing, because the other components are obsolete without it, the report says.
It states that the US must run 20 million tests per day before the economy can be fully reopened.
“It’s a time when a ‘Can Do America’ really shows up and puts itself to work,” said Danielle Allen, lead author of the report and a professor at Harvard University’s Edmond J. Safra Center on Ethics. ABC news.
“What people need to recognize is that a massively scaled test, tracking, and supported isolation system is the alternative to national quarantine.
“We all had to learn PPE [Personal Protective Equipment] and we all had to learn to flatten the curve … now we have to learn about TTSI. ‘
As President Donald Trump steps up public support for lifting the blockages of the coronavirus and reopening the economy, experts have released a ‘road map’ to ensure that this is done safely with more testing, tracking and isolate
The report states that the US must screen for COVID-19 at the rate of 20 million tests per day before the economy can fully reopen. People line up for tests outside a Los Angeles screening location on Monday
Four stages to end lockdowns and reopen the economy
The report outlines four specific steps to effectively end lockdowns with the TTSI method – starting in May and continuing through March of next year.
Phase 1 – May to June: Delay dispersal, build pandemic resilience and mobilize vital workers safely
During this phase, which is expected to last two months, 40 percent of the population – including all essential workers (health workers, firefighters, police, plumbing, etc.) – would be tested at the rate of two million tests per day.
Infected individuals’ contacts would then be detected, placing anyone identified as at risk in assisted isolation with paid sick leave and other resources.
Phase 2 – June to July: Expand the essential workforce and start relaxing collective social distance ordinances
In Stage 2, 70 percent of the population would return to work – including workers who directly support the health sector, such as supply, service, construction workers, construction engineers, maintenance and food workers.
Phase 3 – July to August: End the economic woes of collective home-stayers
Eighty percent of the population would return to work in phase 3, including those working in non-essential sectors.
Phase 4 – August to March 2021: Fully mobilize the pandemic-resilient economy and stay open
During phase four, all workers will return to work reopening all schools, while limited precautions will remain until a vaccine is readily available.
The report estimates that following that plan will cost between $ 100 billion and $ 300 billion over the next two years.
However, the experts noted that those costs are far below the economic losses the US is currently suffering.
“Collective quarantine is costing us $ 350 billion a month … and we’ve seen massive unemployment rates,” said Allen.
She said she believes the roadmap will help America tremendously, both in addressing COVID-19 and in other pandemics that may strike in the future – noting that leaders must override politics to make it possible.
“This must transcend politics …” said Allen. “The point is that we all succeed. No one wants to go to a baseball game and not feel safe. That’s what we need to know to reopen the economy. ‘
On Monday, more than 771,900 Americans tested positive for COVID-19 and at least 41,186 died
TTSI plan part one: increase test capacity to at least 20 million tests per day
The report states that testing is much more effective at reducing the spread of COVID-19 than at-home orders, because the results determine who should be the target for tracking and isolation.
According to current forecasts, test producers will have to take five million tests per day in early June to safely open parts of the economy in late July, the report said.
Danielle Allen, lead author of the report and professor at Harvard University’s Edmond J. Safra Center on Ethics, described the recommendations to ABC News
To fully mobilize the economy, tests need to be increased to 20 million a day, the experts said, noting that this number may not be high enough.
‘We estimate that steady-state testing levels that would allow replacing collective home orders as the primary disease control tool with a TTSI methodology should eventually reach a capacity to test 2 to 6% of the population per day, or between the 5 and 20 million people a day, ‘the report states.
On Friday, about 3.7 million tests were conducted at a rate of 120,000 a day, according to White House officials.
The report notes that those results likely exclude a large group of people who may be carrying the virus without knowing it because they are asymptomatic.
“One of the biggest challenges at COVID is the number of people who are asymptomatic carriers,” said Allen.
The number is difficult to determine, but 20 to 40 percent of people with the virus are asymptomatic. … That means that there are a lot of people who spread the virus and that we have not been able to do anything about it. ‘
According to the White House, about 3.7 million tests have been conducted in the U.S. since Friday at a rate of 120,000 a day
At a news conference last week, Trump said 48 separate coronavirus tests have already been approved by the Food and Drug Administration.
He said the agency is working with 300 companies and laboratories to increase the country’s testing capacity.
One of the largest companies to manufacture the tests, Roche Diagnostics, said it currently produces about 400,000 kits per week.
Abbott Laboratories, which has created a machine that produces results in minutes, has announced it wants to increase production from 50,000 tests per week to one million per week.
At a news conference last week, Trump said 48 separate coronavirus tests have already been approved by the Food and Drug Administration. He said the agency is working with 300 companies and laboratories to increase the country’s testing capacity
Despite their efforts and efforts by many other companies, the US is far from reaching a daily rate of 20 million.
Experts say reaching that level will likely require recourse to the Defense Production Act of 1950, which authorizes the president to oblige private companies to prioritize contracts for materials deemed necessary for national defense.
“You can think of it as a Marshall plan. You can also think of it as Eisenhower’s highway infrastructure, building all those great roads across the country, ”said Allen.
“What we really need is for the federal government to establish a pandemic supply board to coordinate the supply chain and achieve that massive increase as soon as possible.”
Trump has already used the law to order some companies to produce fans, but has not indicated that he plans to do the same for tests – despite mounting pressure from lawmakers.
Democratic senators expressed frustration with the Trump administration’s current test plan during a private conversation with Vice President Mike Pence on Friday.
A source of knowledge of the call told the Associated Press that Maine Sen Angus King, an independent and former governor, at one point told Pence that the government’s failure to develop an adequate national testing regime is a “breach of duty” .
Pence and the top government health officials have insisted that the U.S. have the infrastructure to improve testing, while Trump is adamant that current efforts are among the best in the world.
The report emphasizes that strengthening the tests requires eliminating the supply chain chokeholds and bottlenecks, some of which can be resolved by changing the preferred test methods.
The report describes how the current preferred method of using nasal swabs poses a problem, as the samples must be treated by health professionals wearing protective equipment.
It suggests that the so-called “spit test” approved by the FDA last week could be a safer and faster alternative.
“We should have a way to test that doesn’t require PPE, or you can just spit into this test tube,” Allen said.
“We can get around the problem of transporting biological hazards and that should allow a path to take off.”
The report emphasizes that strengthening the tests requires eliminating supply chain chokeholds and bottlenecks, some of which can be resolved by changing the preferred test methods
TTSI plan part two: Increase contract tracking efforts by hiring hundreds of thousands of disease detectives and pushing digital tracing platforms
The second part of the TTSI containment plan is tracking – identifying anyone who may have been exposed to an infected person so that they too can be tested.
The report calls for a drastic increase in tracing through so-called “disease detectives” who contact people who may be at risk of spreading the virus to others.
“If those contacts are quarantined at home, they won’t expose anyone else, and hopefully the transmission chain will end,” Crystal Watson, a senior scientist at Johns Hopkins, told ABC News.
Watson was one of the lead authors of a recent study by the Johns Hopkins Center for Health Security, which outlined a plan to ramp up tracking efforts by investing $ 3.6 billion in hiring and training 100,000 disease detectives.
The new report goes beyond what the Johns Hopkins study suggested and recommended hiring hundreds of thousands of contact tracers.
More contract tracers mean that potential infections can be identified in hours rather than days.
The second part of the TTSI containment plan is tracking – identifying anyone who may have been exposed to an infected person so that they too can be tested. The report calls for a drastic increase in tracing through so-called “disease detectives” who contact people who may be at risk of spreading the virus to others. Contract tracers can be seen in an office in King County, Washington, in February
The report also highlights how digital contract tracking will strengthen efforts to identify people who may have been exposed to an infected person without knowing it.
While manual tracking involves contacting people you know you’ve seen, digital tracking can alert people you don’t know who may have been close to you in public places.
Google and Apple recently partnered to enable governments and health authorities to use proximity-based contact tracking via Bluetooth.
The companies aim to roll out technology in May that will send app users a warning saying they should be tested if they were recently in the same room with someone who tested positive.
Estimates suggest that the app can effectively disable the virus if 40 to 60 percent of people in a specific area download the app.
Digital contact tracking is already being used in China, Singapore and South Korea, while many other countries have plans to launch it in the coming weeks.
For example, Australia plans to use an existing app called TraceTogether after it proved effective in Singapore.
The report calls for preventive regulation of the technology in the U.S. to ensure that user privacy is safe and protected.
Allen said that better contact tracking, in turn, will reduce the number of tests needed.
“The level of testing we need depends on how effectively we can track people’s contacts, warn contacts about their exposure and test them, and isolate those who are COVID positive,” she said.
Google and Apple recently partnered to enable governments and health authorities to use proximity-based contact tracking via Bluetooth. The companies aim to roll out technology in May that will send app users an alert saying they should be tested if they were recently in the same room with someone who tested positive